“健康中国”背景下我国地区级卫生费用核算分析

Analysis on Regional Health Expenditure Estimates from the Perspective of “Healthy China”

目的:分析2016年我国各地区卫生费用水平差异及变化趋势,为在"健康中国"背景下完善各地区卫生筹资政策提供依据。方法:以来源法卫生费用核算为基础,比较分析地区卫生费用筹资总量、结构和变化趋势。结果:2016年我国各地区卫生总费用占地区生产总值比重呈上升趋势,均超过4.30%,卫生总费用增速差异较大;人均卫生总费用地区间差距大,最高地区是最低地区近4倍;在筹资结构上,仍有12个地区个人卫生支出占卫生总费用比重高于30%;2020年部分地区个人卫生支出占卫生总费用比重存在不达标风险。结论:我国部分地区卫生筹资动员不充分,地区间人群卫生费用利用不均衡;卫生筹资结构存在差距,需加大对卫生筹资公平性的关注;卫生部门应关注卫生系统效率,保障居民健康。

Objective： To present the analysis on regional health expenditure estimates so as to propose suggestions on improving regional health financing policies in the context of ＂Healthy China＂. Methods： Based on health accounts by source, it compared and analyzed regional health financing, its structure and changing trend. Results： In 2016, all regions encountered an increase in term of health expenditure as the share of gross regional product, all exceeding 4.30%, while the growth rate differed among regions. There was a significant difference in per capita health expenditure, and the highest level was aroud four times of the lowest level. In 12 re- gions, the share of out-of-pocket payments （OOP） in total health expenditure was more than 30%. It was predicted that some regions may fail their targets regarding the share of OOP in total health expenditure by 2020. Conclusion： The insufficiency of health expen- diture and unbalance of health service utilization remains among regions; there was a big variation in health financing structure and health financing equity should be attached more importance. Health system efficiency should be improved in health sectors to ensure the value for money and to safeguard residents＇ health.